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There are numerous ethical considerations inherent within the process of assigning a "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000) diagnosis. In this article, general ethics considerations such as informed consent and confidentiality, accuracy of diagnosis, and multiple relationships are examined as they relate to clinical mental health counselors' use of the "DSM-IV-TR". The article concludes with the authors' suggestions for ethically sensitive diagnostic practices.

The counseling profession prides itself on its developmental focus. However, counselors, counselor educators, and supervisors have generally applied only "phasic," and not "stage," theories to counseling and supervision practice and have not incorporated developmental concepts into their teaching. This article continues the effort of rectifying this situation by explicating the relevance of R. Kegan's (1982, 1994) subject-object theory for counseling, supervision, and counselor education. The author reviews Kegan's (1982, 1994) "interpersonal" and "institutional" stages and applies the theory to promoting development beyond the interpersonal stage in 3 case illustrations: a counseling case, a counselor educator's experience, and a supervision challenge.

Spirituality has become increasingly important in counseling, with prayer being the spiritual intervention of choice for Christian counselors. The controversial nature of including prayer in counseling requires careful consideration of ethical issues. This article addresses the intersection of spiritual interventions, particularly prayer, with client welfare, multicultural sensitivity, values, and countertransference. The authors consider the ethical mandates, articulate concerns, and make recommendations.

Counselors pride themselves on their developmental focus; however, they have generally only applied phasic theories to counseling practice and have not incorporated constructive "stage" theories into clinical work. This article begins to rectify that lack by explicating the relevance of Kegan's subject-object theory for counseling practice, by reviewing Kegan's "imperial" stage, and by applying the theory to cases in which at least one of the clients operates primarily out of the imperial stage, cases that include families and/or couples in some way. This is the third in a series of articles on Kegan's theory, begun in "The Family Journal" in July 2006 with an interview of Kegan and an overview of his theory.

Developmental predictors of students' ability to learn counseling skills would help counselor educators select candidates and assist admitted students in their learning. The present research examined the relationship between adult development, as measured by the Learning Environment Preferences test (W. S. Moore, 1989) and the Defining Issues Test (J. Rest, D. Narvaez, M. J. Bebeau, & S. J. Thoma, 1999), and counseling skills performance, as rated by faculty experts using the Counseling Skills Scale (K. P. Eriksen & G. J. McAuliffe, 2003). Data indicate that adult moral development contributed to 18% of the variance in students' counseling skills performance.

Although counselors receive training in both diagnosis and cultural foundations of human behavior, little literature or research integrates these 2 areas in order to facilitate culturally sensitive diagnostic practices. The authors attempt to rectify that lack by providing a review of the literature on the controversies associated with traditional diagnosis of cultural groups that differ from the dominant culture. Practical guidelines for culturally sensitive diagnosis are provided.

Counselor educators need to be able to demonstrate their effectiveness in training new counselors; however, currently few valid or reliable measures exist for assessing educators' impact. The authors describe the development of such an instrument, the Counseling Skills Scale. They began by revising an existing scale and then they solicited feedback from experts and a focus group. They used the instrument to compare beginning counselors-in-training with those who had completed a counseling skills course. Finally, they conducted an item analysis. A paired t test showed significant improvements in counseling skills (t = 4.51, p less than 0.000) from pretest to posttest. Cronbach's alpha showed internal consistency to be 0.90.

Advocacy skills have been identified as necessary for human service professionals. This article presents a 7-stage model for advocacy. It then offers several strategies for teaching advocacy that are based on this model. It is hoped that the model and the learning experiences will increase human service professionals' participation in advocacy work. (Contains 31 references.) (GCP)

Counselors who work with conservative Christians may ask how to respect a client's values when "God" seems to be saying something contrary to what the counselor believes is in the client's best interests. This article portrays conservative Christianity as a culture and articulates conservative Christian beliefs that may challenge the counseling process, suggesting options within the framework of these beliefs. (Contains 68 references.) (GCP)

Uses participant-observation, key informant interviewing, and document analysis to generate a broad understanding of the ways in which counselors advocate for their profession--the elements of an advocacy effort, the possible strategies for advocating, and the people or organizations counselors target when advocating. Compares research results with findings from the public policy and public-relations literature. (Author/GCP)

Spirituality has increasingly become a consideration for mental health practitioners. As a result, spiritual interventions, including prayer, are now more frequently used in counseling. However, no research has explored Christian [...]

The Danish Poison Information Centre (DPIC) regularly receives inquiries about nursing home residents who have been exposed to a medication error. The aim of this prospective cohort study was to describe and discuss the types and consequences of these errors. Data were collected from 1 March 2018 to 31 March 2019. Registered data included characteristics of caller and resident, data related to the suspected medication error, risk assessment and recommendation. Consequences and clinical outcomes were assessed by follow‐up telephone calls. Over the study period, the DPIC was consulted about 145 medication errors occurring at Danish nursing homes. The median number of substances administered by error was two (interquartile range 1‐5). Hospitalization was recommended in 21% of cases. In one‐third of the cases where consultation with the DPIC was done with the resident either on his/her way to or in hospital, hospitalization was found unnecessary, and the resident could have stayed in accustomed surroundings for observation. Follow‐up demonstrated that very few medication errors had a severe outcome. This prospective study illustrates that consulting with a poison information centre can qualify risk assessment and potentially reduce hospital admissions following medication errors in a nursing home setting. [ABSTRACT FROM AUTHOR]

The Danish artist Henry Heerup (1907-1993) has been immensely popular in Denmark, but this quaint popular appeal has contributed to his being primarily considered as a national wonder, unconnected to international avant-garde contexts. This essay focuses on assemblages and stone sculptures from the 1930s as well as writings from the 1940s in which surrealist strategies and materialities are manifest. The works are discussed in relation to surrealism, specifically the subversive surrealism introduced by George Bataille (1897-1962) in order to trace aspects of Heerup's aesthetics that are dark, subversive and irrational, in strategy and theme. These traits in his works diverge from the dominant perception of his art as charmingly idiosyncratic, harmless and innocent. Understanding the darker Heerup allows us to consider him as an artist partaking in and making a unique contribution to avant-garde and surrealist frameworks historically and theoretically. [ABSTRACT FROM AUTHOR]